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A case of Auricular Atypical Fibroxanthoma with Extensive Bleeding
  • Mohamed Abdalla,
  • Brendan Tinwell,
  • Isac Costa
Mohamed Abdalla
University Hospitals of Morecambe Bay NHS Foundation Trust

Corresponding Author:[email protected]

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Brendan Tinwell
University Hospitals of Morecambe Bay NHS Foundation Trust
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Isac Costa
no affiliation
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Abstract

Introduction: Atypical fibroxanthoma is a low grade soft tissue sarcoma infiltrating the dermis containing pleomorphic spindle cells. Pleomorphic dermal sarcoma is a rare dermal tumour on the same morphological spectrum as atypical fibroxanthoma, with greater potential for malignancy. Distinguishing between the two tumours can have a significant impact on management. Case: An 81-year-old gentleman presents with a black haemorrhagic lesion demonstrating features of atypical fibroxanthoma. The diagnostic pathway of this case is followed, focusing on wide local excision and histopathological examination of the offensive tissue, and highlighting decisions made during these stages. Discussion: Common clinical features of atypical fibroxanthoma is detailed, and potential for larger trials to focus on clinical features in symptomatic individuals. The difficulty orientating auricular tissue and methods to reduce potential loss of tissue is discussed. Finally, this report delves into guidelines for wide local excision and what is appropriate for atypical fibroxanthoma or pleomorphic dermal sarcomas. Conclusion: Management of atypical fibroxanthoma can vary from pleomorphic dermal sarcoma or more aggressive sarcomas. This report emphasises the need for a streamlined diagnostic pathway to improve treatment benefit for patients and reduce waiting times.